ABSTRACT
Introduction: Molecular technology has played an important role in arboviruses diagnostics. PCR-based methods stand out in terms of sensitivity, specificity, cost, robustness, and accessibility, and especially the isothermal amplification (IA) method is ideal for field-adaptable diagnostics in resource-limited settings (RLS).
Areas covered: In this review, we provide an overview of the various molecular methods for West Nile, Zika, Dengue and Chikungunya. We summarize literature works reporting the assessment and use of in house and commercial assays. We describe limitations and challenges in the usage of methods and opportunities for novel approaches such as NNext-GenerationSequencing (NGS).
Expert opinion: The rapidity and accuracy of differential diagnosis is essential for a successful clinical management, particularly in co-circulation area of arboviruses. Several commercial diagnostic molecular assays are available, but many are not affordable by RLS and not usable as Point-of-care/Point-of-need (POC/PON) such as RReal-TimeRT-PCR, Array-based methods and NGS. In contrast, the IA-based system fits better for POC/PON but it is still not ideal for the multiplexing detection system. Improvement in the characterization and validation of current molecular assays is needed to optimize their translation to the point of care.
Article highlights
Recent decades have been characterized by an increase in the emergence and the re-emergence of infections due to Arthropod-borne viruses
This narrative review provides an overview of the main molecular methods offering new diagnostic strategies for West Nile, Dengue, Zika, and Chikungunya
Direct molecular methods to detect viral genomes can be assembled in Target analysis (TA) including the nucleic acid amplification (NAA) and the no-amplified nucleic acid hybridization probes (T-nAHP); and in no Target analysis (nTA) such as NNext-GenerationSequencing (NGS)
Sample type, sample preparation, and detection modalities are important considerations for a molecular assay design and choice
Isothermal amplification (IA) method remains the most ideal tool for field-adaptable diagnostics in resource-limited settings with the possibility of performing direct amplification from crude samples without extraction
For multiplexing detection and differential diagnosis, Real-Time PCR and Array-based are more powerful than IA but still not adaptable for field-usage and so is NGS for the identification of unknown strains
An improved design of current assays along with more rigorous characterization and validation are necessary to improve their translation to the point of care
Declaration of interest
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Reviewer disclosures
Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.